Acute Leukemia with a Focus on WHO Classification

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Author: Margaret Reinhart, MS, MLS(ASCP)
Reviewer: Joshua J. Cannon, MS, MLS(ASCP)CMSHCM

This course compares and contrasts acute forms of leukemia based on the WHO classification system for acute leukemia. The most recent updates from WHO are incorporated in the course.

Continuing Education Credits

Objectives

  • Define acute leukemia and how it is differentiated from chronic leukemia.
  • Describe the various causes and risk factors of leukemia, as well as the pathophysiology of the disorder.
  • Describe the major World Health Organization classifications of acute myeloid leukemia and the criteria that differentiate them.
  • Describe the major World Health Organization classifications of acute lymphoblastic leukemia and the criteria that differentiate them.
  • Identify the criteria by which we classify acute leukemias and how the current World Health Organization classifications differ from the previous French-American-British classifications.
  • Differentiate between acute lymphoblastic leukemia and acute myeloid leukemia regarding causes, patient populations, symptoms, and prognostic factors.
  • Differentiate and describe the criteria and diagnostic techniques among the major acute lymphoblastic leukemia and acute myeloid leukemia groups.

Course Outline

  • Definition and Differentiation of Acute Leukemia from Other Neoplastic Disorders
      • Classification and Diagnosis of Hematolymphoid Tumors
      • Definition and Differentiation of Acute and Chronic Leukemia
      • Definition and Differentiation of Acute and Chronic Leukemia, continued
      • Characteristics of acute leukemia include all of the following except:
  • Causes and Risk Factors of Acute Leukemia
      • Causes of Acute Leukemias: Triggers of Genetic Changes
      • Types of Genetic Changes in Acute Leukemia
      • Occurrence and Frequency of Acute Leukemia
      • Match the genetic or chromosomal abnormality to its definition.
  • Introduction to the Classification and Diagnosis of Acute Leukemia
      • Classification Systems
      • Initial Diagnostic Tests and Samples
      • Distinguishing Between Acute and Chronic Leukemia
      • Distinguishing between Myeloid and Lymphoid Lines
      • Cytochemical Stains Used in Differentiating Myeloid Cells from Lymphoid Cells
      • Differentiation between Myeloid and Lymphoid Leukemias Using Cluster of Differentiation Markers
      • Which of the following cytochemical stains would often yield a negative result in AML?
      • True or False: The WHO classification system relies primarily on cell staging, cell morphology, and cytochemical stains.
  • Acute Myeloid Leukemia Diagnosis
      • Signs and Symptoms of Acute Myeloid Leukemia
    • 2022 WHO Classification of AML
      • WHO AML Classification
      • Interpretation of Genetic Designations of the AML Subtypes
      • Occurrence and Common Types of AML
      • Match each notation with its correct description related to cytogenetic nomenclature.
      • The WHO classification of AML can be based on all of the following criteria except:
    • AML Laboratory Testing
      • Basics of Laboratory Testing
      • Cytogenetic Analysis
      • Molecular Genetics of AML
      • Karyotyping used in the diagnosis of AML refers to:
      • AML is commonly caused by mutations that regulate:
      • True or False: When studying the genome of an acute leukemia patient, mutations can be found that are unrelated to the leukemia.
  • AML Prognosis and Treatment
      • Prognostic Factors of AML
      • Types of AML Treatments
      • Newer Treatments
      • Method of AML Treatment
      • Prognosis of AML
      • Important factors that can help determine a patient's prognosis of AML include all of the following except:
      • What is the mechanism of action of chemotherapeutic drugs known as alkylating agents?
  • Acute Lymphoblastic Leukemia Diagnosis
      • Signs, Symptoms, and Background of Acute Lymphoblastic Leukemia
      • Diagnosing ALL
      • True or False: Adults very rarely get ALL; it is typically only found in children.
    • 2022 WHO Classification of ALL
      • WHO ALL Classification
      • All of the following are classification criteria in the WHO classification system of ALL except:
      • True or False: An essential point of differentiation in the WHO classification system of ALL is whether the disorder is leukemia or lymphoma.
    • ALL Laboratory Testing
      • Determination of ALL Lineage
      • Chromosomal Analysis
      • Genetic Analysis
      • A three-year-old has been diagnosed with ALL. Chromosomal analysis performed on this child's lymphocytes showed 53 chromosomes. Which of the following...
  • ALL Prognosis and Treatment
      • Prognostic Factors for ALL
      • Common Cytogenetic Abnormalities and their Prognosis
      • Treatment of ALL
      • The Future of ALL Therapy
      • A two-year-old is diagnosed with ALL. Choose the characteristic that would yield the most favorable prognosis for this child.
  • Acute Leukemia of Ambiguous Lineage and Mixed-Phenotype Acute Leukemia
      • Acute Leukemia of Ambiguous Lineage
      • Blastic Plasmacytoid Dendritic Cell Neoplasm
      • True or False: Acute leukemia of ambiguous lineage (ALAL) is a common leukemia in which the lineage cannot be specified or shows features of both lymp...
  • References
      • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents.   
Author Information: Margaret Reinhart, MS, MLS(ASCP) serves as Senior Lecturer Emerita in Biological Sciences at Saint Joseph's University (formerly University of the Sciences) in Philadelphia, PA, and served as Program Director of Medical Laboratory Science from 1990 to 2020. She also taught hematology, clinical immunology, parasitology, and other related courses. She is currently an adjunct medical laboratory science instructor at Pennsylvania Hospital in Philadelphia, PA. She holds a master's degree in biology and in health care administration.
The author has no conflict of interest to disclose.  
Reviewer Information: Joshua J. Cannon, MS, MLS(ASCP)CMSHCM received his Bachelor of Science and Master of Science in Medical Laboratory Science from Thomas Jefferson University in Philadelphia, PA. He holds Medical Laboratory Scientist and Specialist in Hematology certifications through the ASCP Board of Certification. He was a professor at Thomas Jefferson University for seven years before transitioning into his current role as Education Developer at MediaLab. His areas of expertise and professional passions include clinical hematology and interprofessional education.

This course is part of:
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Auer rods2
translocation t(8;21)
Acute lymphoblastic leukaemia smear B cell acute lymphoblastic
<strong>Chronic myeloid leukemia</strong>
Philadelphia Chromosome: used with permission from Macmillan Cancer Support
AML-M2 associated with a t(8;21) chromosome abnormality
A karyotype of a male with t(6;9)AML (9).
ALL pg39